职业性接触性皮炎患者中天然染料斑贴试验与标准变应原的比较。

Department of Dermatology and Venerology, Faculty of Medicine, Universitas Sebelas Maret/Dr. Moewardi General Hospital, Surakarta, Indonesia.

Cutan Ocul Toxicol. 2022 Sep;41(3):215-220. doi: 10.1080/15569527.2022.2077751. Epub 2022 Jun 30.

BACKGROUND

Occupational contact dermatitis (OCD) is a skin disorder caused by contact with any substances found in the workplace. Occupational contact dermatitis is second most common occupational disease (15% of all cases of occupational disease). Occupational contact dermatitis is divided into allergic contact dermatitis (ACD) and irritant contact dermatitis (ICD) which is 80% of cases that affects hands. Batik is an art that is painted on cloth, it is one of Indonesian cultural heritage. Batik workers have a higher risk of obtaining OCD due to exposure to chemicals and fluids used during work. Natural dyes used in the dyeing process are less likely to cause ACD than standard allergens. Some of the natural dyes used in the dyeing process in batik industries are , sappan wood (), and Mahagony () cause skin sensitisation.

OBJECTIVE

To compare the results of patch testing between natural dyes (, sappan wood (), and Mahagony () with standard allergens (p-phneyldiamine 0.1%, potassium dichromate 0.5% and formaldehyde 0.1%) as a cause of ACD in batik workers in Surakarta, East Java, Indonesia.

METHOD

A cross-sectional study was conducted on 63 subjects batik workers with OCD in Surakarta, East Java, Indonesia. Subjects were patch tested with three standard allergens (p-phenylenediamine 0.1%, potassium dichromate 0.5%, and formaldehyde 1%) and natural dyes (, sappan wood (), and Mahagony (). A closed patch test was evaluated 48 and 96 hour later. Screening of OCD in batik workers in Surakarta, East Java, Indonesia was based on Nordic Occupational Skin Questionnaire NOSQ-2002, and diagnosis of OCD was based on Mathias criteria (at least 4 out of 7 criteria were met). Data were analysed using a non-parametric Chi-square test with SPSS 21 with a significant difference if the -value < 0.05.

RESULT

Natural dyes significantly caused allergic contact dermatitis in batik workers in Surakarta, East Java, Indonesia than standard allergens ( = 0.016). A positive patch test was found in 11 patients, standard allergen p-phenylenediamine (PPD) 0.1% was seen on one patient, potassium dichromate 0.5% on two patients, and formaldehyde 1% on two patients. A positive patch test using was found at one patient, sappan wood () in three patients, and Mahagony (Swietenia mahagoni) in five patients.

CONCLUSION

Natural dyes cause more positive patch test results in batik workers.

背景

职业性接触性皮炎（OCD）是一种由工作场所接触任何物质引起的皮肤疾病。职业性接触性皮炎是第二常见的职业病（占所有职业病的 15%）。职业性接触性皮炎分为过敏性接触性皮炎（ACD）和刺激性接触性皮炎（ICD），其中 80%的病例影响手部。蜡染是一种在布上绘制的艺术，是印度尼西亚文化遗产之一。由于工作中接触到化学品和液体，蜡染工人患 OCD 的风险更高。在染色过程中使用的天然染料引起 ACD 的可能性小于标准过敏原。在蜡染行业的染色过程中使用的一些天然染料，如苏木（）、紫檀（），会引起皮肤致敏。

目的

比较天然染料（苏木（）、紫檀（））与标准过敏原（对苯二胺 0.1%、重铬酸钾 0.5%和甲醛 0.1%）在引起印度尼西亚苏拉卡尔塔蜡染工人 ACD 方面的斑贴试验结果。

方法

在印度尼西亚苏拉卡尔塔对 63 名患有 OCD 的蜡染工人进行了横断面研究。受试者用三种标准过敏原（对苯二胺 0.1%、重铬酸钾 0.5%和甲醛 1%）和天然染料（苏木（）、紫檀（））进行斑贴试验。48 小时和 96 小时后进行封闭斑贴试验。印度尼西亚苏拉卡尔塔蜡染工人 OCD 的筛查基于北欧职业性皮肤问卷 NOSQ-2002，OCD 的诊断基于 Mathias 标准（满足至少 4 个 7 个标准）。使用 SPSS 21 的非参数卡方检验分析数据，如果 -值<0.05，则差异具有统计学意义。

结果

天然染料在引起印度尼西亚苏拉卡尔塔蜡染工人 ACD 方面明显比标准过敏原更具致敏性（=0.016）。11 例患者出现阳性斑贴试验，1 例患者对标准过敏原对苯二胺（PPD）0.1%呈阳性，2 例患者对重铬酸钾 0.5%呈阳性，2 例患者对甲醛 1%呈阳性。1 例患者对苏木（）呈阳性，3 例患者对紫檀（）呈阳性，5 例患者对紫檀（Swietenia mahagoni）呈阳性。